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Войти в исследования International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
Obstetric and neonatal outcomes in clinically diagnosed placental abruption with and without placental histopathologic confirmation-A retrospective study.
СтатьяНазвание и аннотация: Перевод в очереди
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Gonen Noa, Mor Liat, Rabinovich Daniel, Kleiner Ilia, Schreiber Letizia, Barda Giulia, Weiner Eran, Barber Elad
Аннотация
OBJECTIVE: Placental abruption is a major obstetrical complication bearing potentially life-threatening consequences. Though the diagnosis of placental abruption is a clinical one, the nonspecific nature of common presenting symptoms, mainly vaginal bleeding and contractions, pose a challenge, and the contribution of placental pathology has been debated. In this study, we assessed the clinical significance of related placental lesions by comparing obstetric and neonatal outcomes among cases of placental abruption with versus without supporting histopathologic placental lesions.
METHODS: We retrospectively analyzed placental abruption cases diagnosed during an 8-year period at a single tertiary center. Maternal, neonatal, and placental outcomes were compared between cases of placental abruption with versus without histopathologic placental lesions. The primary outcome was a composite of severe neonatal morbidity and included 1 ≤ of the following: seizures, intraventricular hemorrhage, hypoxic-ischemic encephalopathy, periventricular leukomalacia, necrotizing enterocolitis, blood transfusion or neonatal death.
RESULTS: A total of 305 clinical placental abruption cases were included: 95 in the placental abruption with histopathologic lesions group (31.3%) and 210 without such lesions (68.8%). The group with histopathologic lesions was characterized by higher rates of vaginal bleeding at presentation and prematurity (P = 0.012 and P < 0.001, respectively). Additionally, this group had substantially higher rates of composite severe neonatal outcomes (the primary outcome) (P = 0.005) and concurrent maternal vascular malperfusion lesions (P < 0.001).
CONCLUSION: Our findings shed light on the association between placental abruption-related histopathologic lesions and adverse obstetric and neonatal outcomes. Thus, histopathologic examination can be advocated in suspected placental abruption, as patients with related placental lesions may require closer follow-up in subsequent pregnancies.
METHODS: We retrospectively analyzed placental abruption cases diagnosed during an 8-year period at a single tertiary center. Maternal, neonatal, and placental outcomes were compared between cases of placental abruption with versus without histopathologic placental lesions. The primary outcome was a composite of severe neonatal morbidity and included 1 ≤ of the following: seizures, intraventricular hemorrhage, hypoxic-ischemic encephalopathy, periventricular leukomalacia, necrotizing enterocolitis, blood transfusion or neonatal death.
RESULTS: A total of 305 clinical placental abruption cases were included: 95 in the placental abruption with histopathologic lesions group (31.3%) and 210 without such lesions (68.8%). The group with histopathologic lesions was characterized by higher rates of vaginal bleeding at presentation and prematurity (P = 0.012 and P < 0.001, respectively). Additionally, this group had substantially higher rates of composite severe neonatal outcomes (the primary outcome) (P = 0.005) and concurrent maternal vascular malperfusion lesions (P < 0.001).
CONCLUSION: Our findings shed light on the association between placental abruption-related histopathologic lesions and adverse obstetric and neonatal outcomes. Thus, histopathologic examination can be advocated in suspected placental abruption, as patients with related placental lesions may require closer follow-up in subsequent pregnancies.